Before You Begin

You are probably raring to start Atkins and begin losing weight. But there are two medically important steps and several practical preparations that will lay the groundwork for your success. First, a crucial warning: People with severe kidney disease (creatinine over 2.4) should not do any phase of Atkins unless ordered to do so by their physician. Also, pregnant women and nursing mothers may do the Lifetime Maintenance phase but should not do any of the weight loss phases of Atkins.

The first thing you must do is review any medications you take and make a doctor's appointment to get a complete physical, including some blood work and other tests. I'd like you to understand why having a medical workup before beginning Atkins is so important, both from a health perspective and to help motivate you to follow the program faithfully.

A patient of mine named David French-a 52-year-old stockbroker-had tried countless diets and failed on all of them. He came to me somewhat reluctantly-nagged, I suspect, by his wife and children. During our first conversation, he quickly expressed his skepticism, groaned at the thought of taking vitamins and seemed to me like someone who would not stick with the program. Although he weighed 206 pounds at only five feet eight inches tall, he had no obvious health problems other than generalized fatigue and difficulty with even very mild physical exertion.

"Let's at least check your blood lipid levels, Mr. French," I said, "and then we'll have some idea of whether you have anything to worry about." (The word lipids is medicalese for cholesterol and triglycerides, traditionally regarded as the main blood indicators for heart disease risk.) The blood tests were enlightening. His total cholesterol was a whopping 284 and his triglycerides level was an incredible 1,200. At our next meeting, I let him have it with both barrels: "If you don't do something soon, I'd say you're probably going to die in the next year or two, Mr. French "

That caught his attention. In all probability, I told him, a heart attack or a stroke would be his undoing. He also showed signs of being a borderline diabetic. His condition was completely reversible, but when he left my office that day I didn't think he'd make the effort to reverse it.

I was wrong. Dave started doing Atkins, and six months later, he weighed 162 pounds, his total cholesterol was 155 and his triglycerides were 90. He had been a carbohydrate eater his whole life-he'd hit the coffee cart for bagels and rolls, stop on the way home from work for a calzone and drank soda pop every day-but Dave thrived on my program, reassured by the fact he could eat until he was completely satisfied. "If you're hungry, eat," I said.

I also persuaded Dave to do a half hour of exercise four times a week. He soon found that he slept better and felt far less tired during the day. Also, physical exertion was no longer beyond him.

Dave is a slim and healthy man now and he won't let himself slip into his old ways. "I have a picture that I keep on the desk in my office that shows the maximum me," he says. "I look like

I'm going to have a baby. I keep the photo right there where I can see it, to remind me of what I'll never be again. Nowadays, I don't even look like the same person."

Even more important, Dave French probably wouldn't be alive today if the results of his blood work hadn't shocked him into changing his ways.

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